PRF

 

What is Pulsed Radiofrequency Treatment?

Pain can be experienced in joints due to degenerative changes or arthritis. Pain can also be experienced due to nerve damage. There is a treatment for the damaged nerves or the nerves that supply the painful joint(s) called pulsed radiofrequency neuromodulation.

Pulsed radiofrequency treatment involves applying an electrical pulse through a special needle to a target nerve. This treatment affects nerve conduction and may reduce pain.

The treatment does not destroy the nerve and consequently does not cause weakness or loss of normal sensation.

 

How long will the pain relief last after Pulsed Radiofrequency treatment?

The length of pain relief varies, but the treatment may provide pain relief for weeks to months. Even if the nerve blocks worked, the procedure may not always be efficient. It is important to note this is not a permanent solution. After time, nerves recover from the procedure and pain returns. Once this has occurred, the procedure can be repeated if necessary. Underlying degenerative changes in the nerves or joints are unable to be treated through this procedure.

 

Will I be awake during the procedure?

All patients are offered the option of sedation, with most people electing to be sedated. This reduces the risk of experiencing discomfort during the procedure.

 

Is the procedure painful?

You may be administered local anaesthetic injections at the start of the procedure. Following the procedure, you may experience discomfort once the numbing injection wears off.

 

How do I prepare for the procedure?

It is important to advise medical staff if you are:

  • Taking blood thinners – these may need to be stopped for some time prior to the procedure. This depends upon the site.
  • Diabetic
  • Pregnant, or have a chance of being pregnant
  • Suffer from any allergies (such as iodine, latex, shellfish, local anaesthetics, or anything else)
  • Are feeling unwell or have an infection
  • Are implanted with a medical device.

Before the procedure, you may be advised to:Fast for 6 hours before the procedure. You will be notified by staff of when to start fasting.

  • Fast for 6 hours before the procedure. You will be notified by staff of when to start fasting.
  • If you have a neurostimulator or pacemaker you should let staff know as precautions may need to be taken.
  • It is usually ok to drink clear fluids up until 3 hours prior to the procedure.
  • Continue taking usual medication, unless otherwise advised.
  • Ensure you have someone to accompany you home after the procedure.

 

What does the procedure involve?

Here’s what you can expect will happen on the day of your procedure:

  • You will be asked to change into a hospital gown
  • If you have selected to be sedated, you will meet with an anaesthetist
  • You may have a small cannula inserted into a vein
  • You may be given a mild sedative
  • Throughout the procedure, your heart rate, blood pressure and oxygen levels will be monitored
  • You will be placed onto an x-ray table. Here, the skin over the area to be injected is cleaned and has sterile drapes applied
  • If necessary, a local anaesthetic may be injected into your skin
  • Using either an x-ray machine or ultrasound machine, a small needle will be guided towards the correct target
  • If necessary, contrast dye may be used to help confirm the position of the needle
  • Pulsed radiofrequency is performed and local anaesthetic, sometimes including steroid, is injected.
  • In some cases multiple injections may be required.

The whole procedure usually takes 30 to 45 minutes, as well as recovery time.

 

What are the potential complications?

Every invasive procedure comes with the risk of complications. While this procedure is very safe, the risks include:

  • Discomfort felt at the site of the injection
  • Infection
  • Bruising
  • Muscle weakness
  • Bleeding
  • Allergic reaction
  • Pain levels remain the same due to failure of the procedure
  • A burning sensation or numbness of a patch of skin. This can be caused by temporary nerve damage. Up to 5% of cases can have this occurrence, with symptoms sometimes lasting several weeks.
  • In extremely rare cases there may be permanent damage to nerves or the spinal cord. This can result in weakness, pain or loss of sensation.
  • Steroids can cause numerous side effects such as transient flushing, mood swings and high blood sugar levels, particularly for diabetic patients. While steroids were not designed for this procedure, they have been used widely used in this procedure for years without complications.

Please discuss further with your doctor or anaesthetist about the risk of sedation.

 

What happens after the procedure?

  • You will be relocated to a recovery area, where you will be monitored for 60 to 90 minutes. You will then be ready to go home.
  • When returning home ensure you have someone to take you home and stay overnight.
  • Effects of sedation may last up to 24 hours. This may cause you to forget information given during the procedure. This is completely normal and not a side effect to worry about.
  • During the 24 hours after the procedure, you should not drive, drink any alcohol, operate machinery, sign legal documents, make important life decisions or travel unaccompanied
  • When you wash the following day you can remove the dressing
  • As the local anaesthetic wears off, you may notice that pain will return. In some instances, pain and stiffness will continue for several days. To help with symptoms, you can apply an ice pack to the necessary area for 10 minutes at a time for 1 to 2 days following the procedure. Pain killers can also be taken to ease discomfort.
  • If steroids were injected during your procedure it may take several days to notice any benefits. You may also notice symptoms such as a flushed face, mood change or a high blood sugar level for diabetics.
  • Make sure to gradually increase your daily activities. Avoid rapidly increasing physical activity and only complete what you can tolerate.
  • If you have symptoms such as severe pain, swelling, discharge or bleeding from the site, make sure to contact QPain, your General Practitioner, or your local hospital’s Emergency Department.

 

Consent

Make sure you have discussions with your doctor before the procedure. It is important that you are completely aware of the details of the procedure, and you have been informed of what it involves and any side effects.

As a patient, you will be required to sign a form of consent. This states you have been informed about the procedure and it’s benefits, risks, alternatives and alternative options if you do not proceed. It is important to know you can withdraw content at any time right up until the start of the procedure.

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